S tudies have shown that greater weight loss during initial weight loss management has proven to be a predictor of maintained weight loss and the reduction of obesity. Additional baseline determinants of successful weight maintenance have yet to be identified.
To address this gap in information, Suzanne Phelan, PhD, and colleagues developed a study enlisting 2,843 participants in the Weight Watchers weight loss program who maintained a weight loss of at least 9.1 kg for at least one year. Participants answered questionnaires that addressed behavioral, psychological, and home environmental issues at the start of the study and one year later. The study team found discerning features between gainers and non gainers to be a lack of ability to deal with uncomfortable food cravings, urges, and a desire to overeat; self-monitoring; body image; and satisfaction with one’s body and greater increases in disinhibition and physical pain. Dr. Phelan discussed the findings of the study with Physician’s Weekly.
PW: Why did you feel weight regain needed exploration?
Dr. Phelan: Few studies have comprehensively examined predictors and correlates of weight loss maintenance within commercial weight management programs, which reach 10%-15% of the US population and are clinically recommended. Knowing the behavioral, psychological, and environmental factors that shape success in this setting can inform future programs.
What are the most important findings from this study?
The factors that may best help prevent weight regain were consistent monitoring of diet and weight (eg, keeping a record), greater acceptance of uncomfortable food cravings, and reduced disinhibition when faced with food cues. Also, less pain and a more positive body image at any weight, shape, or size were important.
How can these findings be incorporated into practice?
Providers can emphasize that bodies are beautiful in any shape and size and acknowledge challenges in maintaining long-term weight control. Behavior changes such as self-monitoring may help patients meet their weight control goals. Also, providers can query whether and how a patient’s experiences with physical pain affect their level of physical activity.
What would you like future research to focus on?
Randomized control trials in diverse populations are needed to determine whether improved outcomes are obtained via weight maintenance interventions targeting overeating in response to internal and external food cues, declines in self-monitoring, and body image.
Is there anything else physicians should know about your research?
This is the first known study to investigate determinants of weight loss maintenance comprehensively and prospectively in a widely available commercial weight management program. Findings should be interpreted in the context of the study’s limitations. Participants were predominantly female, non-Hispanic White, and with higher income. So, these findings might not generalize to other populations of weight loss maintainers. A grant from Weight Watchers funded the study. In the published findings of the study, printed in the journal Obesity, Dr. Phelan and colleagues express a hope that researchers, clinicians, and policymakers consider the study’s conclusions when developing interventions to help those who have achieved clinically significant weight loss to maintain that loss long term.
